Can't sing

Recuperating from open-heart surgery is a long process.  

Initially I must not lift anything heavier than one kilo.  This is very limiting.  A one-litre bottle of milk is about right.  Opening a ring-pull can of tuna requires too much force.  Even clicking the lid on the toothpaste tube strains the chest muscles.  

Gravity is not my friend - if I tilt my body, I feel my sternum pulling apart.  I have to sleep lying on my back.  I can't change position at all, so I wake frequently feeling uncomfortable.  

And as I feared, I can't sing.

Three weeks after the operation, my chest is still giving a lot of pain.  I can take a big breath, but it's an effort, and I can't sustain it.  I can produce a sound but it is thin and lacks tone.

Normally, singing is very enjoyable physically.  Now it's not.  It feels uncomfortable.

More disturbingly, I'm not interested in music.  I'd thought that music would be my companion during my convalescence.  I'd imagined myself on the couch listening to my CDs, but I don't feel like doing that.

I back up a lot of my CDs to i-Tunes, in case any of them break or get lost.  It's insurance for my valued collection.  But I'm not that interested in listening to them.

My house is strangely silent.

I'm not getting any joy from music.  The emotional response I would normally feel is missing.

Just as food is not tasty; chocolate tastes like cardboard, and coffee lacks its usual rich aroma - music seems like background noise.  I feel nothing.  My musical libido is gone.

Is it the pain?  Is it the anaesthetic?  Lack of sleep?  Or my inability to sing along?

Could it be the medication I'm taking?

I'm taking various pills, including beta-blockers.  These slow the heart rate and prevent it from slipping into an irregular pattern.  Some people take them for stage fright, as they relieve anxiety and make the user feel calm on stage.  But other people say that they are not good for performance, because these pills drain all the passion out of it.

At the four-week mark I decide to try some singing practice.  But it doesn't feel good.  I can't sustain the air pressure inside me.  It's like running with a sprained ankle.

Yet, I start to feel impatient to achieve something.  I go online and purchase some "teach yourself piano" books on the Internet.  I've had my piano tuned and it's sounding good.  The tuner tells me it's a nice piano, and it will stay in tune better if it's played.

Slowly, music begins to move me again.  It happens very gradually - a blue note; a cadence; a chord progression will stir something emotionally in me.  I just have to trust that my desire will return.

In Week 6,  I return to singing lessons.  There's much less pain now, and I can stop taking the beta-blockers.  My teacher guides me carefully - we joke that we wouldn't want to burst anything.  I'm only half-way to being fully-mended.  We pick up the threads from my last lesson.  

Finally, I'm on the road back to performing.

Time to go home

Apparently during my week in hospital, I've lost just a quarter of a kilogram.  How can this be?  I've had three days of fluids only, two days with little appetite and two days of not fancying hospital food.  And no alcohol for a week.  Sorry, the scales must be wrong.

As well as the big gash in my chest, my sternum is swollen and my torso is decorated with bruises and puncture marks.

Nurse Min is with me again, after her weekend off.  She describes driving through the Barossa Valley with her husband.  They had lunch at a pub and bought local jams and other produce.  I haven't been outside for a week.  I can't wait to take a breath of fresh air.

Min's husband used to be an oil driller and they lived in various places around the world.  Due to industrial accidents, he landed in hospital several times.  Visiting him in an overseas hospital, she decided to change his sheets.  This task became an archeological dig; removing the sheet revealed another one soaked in blood, and under that was one covered in mud.  The doctors would sit down with the patients and have a smoke.  And the patients would order their meals from MacDonalds or Kentucky Fried Chicken.

She also worked at another overseas hospital.  The patients would store their hand-guns and knives in the bedside table drawer.  And after welcoming a new patient, she had to ask for the cheque; the cost of the hospital stay had to be paid in advance.   If the patient had health insurance, reimbursement could be claimed later.  People would mortgage their homes, or borrow the money from loan sharks.

I feel very fortunate to have had such good care.

But my lunch is not very nice - even the dessert looks horrible.  The fact that I'm complaining suggests it really is time to go home.  Instead, I eat some of the chocolates brought by friends.

My husband and son stack the flowers onto a trolley.  Slowly we make our way down to the exit.

When we turn into our street I feel overjoyed.  I'm going home to my couch and my DVDs and my own bed.

My son makes a pot of coffee.  I sit down to eat a cupcake made by a friend.  It has cream cheese icing and crunchy almond slivers on top.  I watch two episodes of "Mad Men" on DVD, as rain pours down outside.

I have to sleep on my back, in the same position, all night; forever, perhaps.  Through habit, I wake at the hospital observation hours of 2 and 6 am.

At dawn, I slide back under the covers and into a dream in which I am riding a bicycle on a sunny day, along a riverside path.  The grass is tall and I am not wearing a helmet.

"Take a deep breath"

The week in hospital requires patience and resilience.

Some days I wake up feeling great, but it doesn't take long to slip back into fatigue and I just want to lie down.

I can't reach my phone.  Drugs are keeping the pain under control, but my chest is very uncomfortable, and my range of movement is limited.  The telephone cradle is very light, so that if I can manage to get a grip on the handset, the spiral cord doubles up on itself and the whole unit clatters to the ground.  This means that the first thing my caller hears from me is a swear word.

On the Friday I inquire if there is a hairdressing service.  My hair hasn't been washed for a week, and if I can only lift one kilogram, how am I going to hold a hairdryer above my head?   A lady can come in to dry it for me, but I have to wash it myself.  With effort, I manage to do this.  The hairdresser arrives, and as soon she starts on me I can tell that there is no particular expertise being applied.  It is the worst blow-dry ever, finished with sticky lacquer.   I suppose it's better than what I could do one week after open-heart surgery.  My daughter comes in with a straightener and fixes it for me.

Part of the therapy is to cough frequently - ten times per hour.  Hugging a folded towel lessens the pain. My cardiologist listens to my chest and observes that air is not reaching down fully into my right lung.  He asks the nurse to get me a "tri-flo".  It turns out to be a sort of toy that requires you to suck in deeply and make three balls levitate into the air.  It's great because it sets you a goal.  Instead of "breathe in deeply", it indicates how deeply you can breathe and still be safe.

Apparently they used to give everyone one of these, but research found that not everyone benefits from it.  I'm glad I told my doctor about the singing, because I think this why I've been given one.  I want to regain full lung capacity and he's offered me a way to do it.  It's hard at first, but I persevere, and within twenty minutes I've cracked it.

Home away from home

My room in the Cardiac Surgical Unit soon resembles a florist shop.  There are vases of flowers on every ledge and bench.

The first night, there is no point trying to sleep.  They check on me every hour, and between visits, a blood pressure cuff auto-inflates eerily, like something in a surrealist movie.

My achievements for the first day are to get out of bed and into an armchair, and to take myself to the bathroom.

There's a chair in the shower, and I'm happy to use it.

They remove the dressing from my wound and invite me to dab it with a damp face-washer.  Red lines appear on the white cloth.

My lips are dry and peeling.  I have a streaky spray-tan; I've been painted head-to-toe in Bettadine.  I feel a bit like the girl in the Bond movie "Goldfinger", though unlike her, I'm alive.

Gradually they take out the various tubes and needles.

The days go by, to a rhythm of pills and injections.

One morning, I wake at dawn and wonder where I am.  I don't like my hotel.  I want to get away, then realize that I can't.  Panic threatens to overwhelm me.

At night, I'm lying in bed and feel the sensation of being in a sleeper compartment of a moving train.   It feels as if the train is swaying side to side.  But I am motionless, and the bed is not moving, either.  This is a mystery I cannot solve.  The next morning the surgeon comes in and I tell him about it.  He says "Oh, that.  That is just your heart moving around.  That misery will settle down in time."

The surgeon is proud of his work.  He describes it as "a perfect repair".  

I am happy to applaud.

A one-week "holiday"

The evening before the operation, my husband and son come to visit me.  They bring flowers, and I hope they can be kept for me until after my 24-hour stay in the Intensive Care unit.

We watch the X-Factor on TV, and I recognize one of the contestants, Michael, who is a regular at Cabaret Live.   He sings extremely well and makes it through the audition process; on to "boot camp".  I cheer loudly for him.

They leave, taking the lap top with them, as I won't be able to lift it after the operation.

I've been given two sleeping pills and I hope they really do knock me out.  If I'm semi-comatose in the morning, that will be great.  I gulp down the pills.

But at 6 a.m. I'm awake, bright and alert.  I shower, and as instructed, swab every inch of my body with an antibiotic sponge from a sealed packet.  Then I put on the hospital gown.  Min comes in and tells me I've got it on back to front.  This one opens at the back.  This seems strange, since they're going to operate on my chest.

She gives me another two sleeping pills, and I swallow them gratefully.

They wheel me into the operating theatre, and I say "Hi" to the team.

And that's it for a while.  No dreams; no white lights; no revelations.

Then I hear my surgeon speaking.  He says "We were able to repair the valve; we didn't have to replace it".

I feel overjoyed and start to cheer.  But when I open my mouth nothing happens, so I cheer with my hands.  The surgeon isn't speaking to me, though.  He's describing the operation to some other people, perhaps a group of students.

But now I know the news.  It's very good news.

I can't swallow, yet I need to, badly.  They wrench the tube out of my throat.  That feels better.  But now I can't breathe.  Now they get an oxygen mask onto me.  I still can't speak.  My husband is at my side, encouraging me.

The nurses haul me into a semi-sitting position, make me hug a folded towel and command me to cough, to re-inflate the lungs that have been flattened.

Then the deliveries begin.  First, a "Get Well" card.  Then, as if by magic, Julie from Cabaret Live appears at my bedside with a bouquet of flowers from the cabaret group. Then some flowers from some other friends.

Flat on my back, I constantly demand crunchy ice chips to slake my thirst.

I hear someone say "It's too soon to know if she'll have a stroke".

Note to self: Don't have a stroke.

Then they cart me back to the ward to begin my one-week "holiday".

The Magical Mystery Tour

On Sunday morning, I arrive at the hospital and am escorted to my room.  The window overlooks a light industrial area.  I wonder why there is a little desk in the corner.  I  don't think I'll be doing any work.

The nurse who greets me introduces herself as Min.  She provides a bit of an overview of what to expect.  They are going to cut through my sternum and it will be wired together; I'll need to treat it gently while it mends.  In the weeks after the operation I must not lift anything heavy.  A maximum of one kilo to begin with.  My laptop weighs nearly two kilos.  A kettle full of water will be too heavy.  If I want to chop vegetables, I should sit down at the table, not bend over the kitchen counter.  If I do too much lifting, I might feel my sternum move out of alignment, and I will have to come back to have it re-set.

Some people do end up back in hospital, apparently.  I want to avoid this fate.

During the morning I am visited by a procession of doctors and nurses with varied duties.  The surgeon bounces in, a vision of vibrant health and energy.  He is wonderfully reassuring.  It makes me wonder how one learns such a skill.

I'm first on his list for tomorrow.  When I wake up, I'll know my future.  Either my own valve will have been repaired, or I will have a metal replacement valve.  If I have the new valve, I'll start taking Warfarin on Wednesday night.

While I'm waiting for a chest x-ray, I meet a man who is also having heart surgery tomorrow morning.  He's having a valve replacement, as he has been told that his valve is beyond repair.  This is very unfortunate for him, but it gives me added encouragement.  We have the same surgeon.  Now I know that he doesn't tell all his patients that he will attempt a repair.  Hopefully, his assessment of my chances is realistic.

Lots of people are wishing me well, keeping fingers crossed for me, praying, sending healing thoughts, lighting candles and appealing to the angels.  I'm grateful for every thought and wish.

They give me a booklet about heart health - what to eat and what not to eat.  Dutifully I read it, and conclude that my diet is reasonably good.  I don't have blocked arteries.  I'm going to keep on doing what I've been doing.  Anyway, they bring me a huge plate of roast beef with gravy for lunch, and a package of sweet biscuits with my afternoon cup of coffee.  I don't think I need to be obsessed with my diet.

Abandoning the hospital snack, I go downstairs to Hudsons and get myself a proper coffee and a lemon curd muffin.  I eat the whole thing.  It's delicious.  There is no point dieting today.

I sit around all afternoon listening to Bossa Nova, reading Harvard Business Review, fiddling about with Facebook, and blogging.  I do things I know I won't feel like doing after the operation.  From time to time, staff come in and perform various tests.  They are caring and reassuring.

It begins to feel like a new adventure.  They assure me I won't remember anything about the operation, but the aftermath and the road to recovery will be a once-in-a-lifetime experience.  When I get up tomorrow morning I'll be embarking on a magical mystery tour.